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February 10, 2013

DoD’s new Android Biofeedback App connects to wearable devices

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The National Center for Telehealth and Technology (T2) an agency of the Department of Defense, has been introducing online and
mobile health tools for people in the military, veterans, and their
families since 2008. Their newest offering, BioZen,
is an effort to get ahead of the trend of personal sensors and provide a
free mobile tool to help people use those sensors to improve their
health through the practice of biofeedback in app form.

“One of the things we do here at T2 is constantly look for ways to
innovate mobile health. Wearable technology is one of our interests,”
David Cooper, a psychologist at T2, told MobiHealthNews. “One thing we
didn’t see a lot of was people using biosensors for biofeedback. But we
found a way to integrate some biosensors through the mobile phone using
Bluetooth.”

Biofeedback is a therapy wherein patients wear sensors while
experiencing a problem like chronic pain or migraines. By seeing exactly
how their physiological response changes throughout the experience,
patients can gain control over those responses and, therefore, over
their symptoms. It can be used in conjunction with other therapies or by
itself: sometimes the awareness itself is therapeutic, other times
biofeedback is a tool for determining what’s the most effective way of
dealing with a condition.

Biofeedback is an appealing area for mobile health because
traditional biofeedback technology is cumbersome, requiring the patient
to be hooked up to a lot of wires with limited mobility. Mobile
biofeedback, which only requires some wireless sensors and a smartphone,
not only allows a patient to take the therapy home and use it more
often and more casually, it can also be used in the clinic, lowering the
price point and effort involved.

Cooper says there is a stigma attached to mental health for many
returning servicemembers. Part of the idea behind a biofeedback app is
to provide a discreet personal treatment option for people who don’t
want to take medication or don’t want others to know they’re in therapy.

“That’s why we like developing for mobile devices,” said Cooper.
“People don’t know if you’re checking Facebook or learning about your
PTSD.”

For that reason, the app is designed to work in the context of
therapy, but it also includes tutorials so people can learn to do
biofeedback on their own. It includes a highly informational graph-based
interface, but it also includes a single-variable pictorial interface
where, for instance, a picture of a tree becomes brighter and more
detailed as your gamma waves increase.

The BioZen Android app works with a variety of commercially available
sensors with open APIs. Sensors the app can interact with include
electroencephalogram (EEG), electrocardiogram (ECG), electromyography,
galvanic skin response, respiratory rate, and skin temperature. The app
can either work with just one sensor or a whole suite. The device
currently works with brainwave sensors from NeuroSky and BrainAthlete, as well as physiological sensors from Zephyr Technology and Shimmer Research, sensors Cooper said were chosen because they are commercially available and have open APIs.

“We’re trying to move into a more open framework when it comes to
health sensors,” Cooper said. “We know that’s an important consumer
area, we know its going to be important in mHealth coming up. So we’re
trying to incorporate as many of these APIs in our future products as we
can.”

Cooper said T2 likes to make its apps multiplatform, but because of
the difficulty in interfacing with Bluetooth, he doesn’t think an iOS
version of BioZen is likely.

T2 has 10 Apple and Android health apps available, including a mood tracker,
an app for managing with PTSD, and an app to help combat stress with
breathing exercises. T2 recently updated the mood tracker app with a new
capability: users can now export and share their mood records with
friends or care providers. In addition, the agency maintains two online
communities to help people in the service and their families deal with
the wide range of issues affecting them: afterdeployment.org and militarykidsconnect.org.

Cooper said the DoD is careful to only release apps based on
research-driven practices, but they don’t wait until the apps themselves
are clinically proven to release them. T2 has published 75 papers since
2008, however, and is planning to do efficacy studies on BioZen in the
future.